Healthcare Provider Details

I. General information

NPI: 1225610389
Provider Name (Legal Business Name): POUDRE VALLEY HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 QUENTIN ST
AURORA CO
80045-7136
US

IV. Provider business mailing address

7901 E LOWRY BLVD # F402
DENVER CO
80230-6507
US

V. Phone/Fax

Practice location:
  • Phone: 970-329-9754
  • Fax: 844-691-1657
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: DAVID THOMPSON
Title or Position: CFO
Credential:
Phone: 970-495-7000